Hypersensitivity Pneumonitis

Question 0

HP caused by thermophilic actinomycetes found in sugar cane

Answer 0

Bagassosis

Question 1

Most common types (3) of hypersensitivity pneumonitis in the US

Answer 1

Farmer’s lung, bird fancier’s lung, and chemical worker’s lung

Question 2

Antigen responsible for cheese washer’s lung

Answer 2

Penicillium casei

Question 3

Antigen responsible for chemical worker’s lung

Answer 3

Isocyanates

Question 4

Antigen responsible for detergent worker’s disease and familial HP

Answer 4

Bacillus subtilis

Question 5

Two genera of thermophilic actinomycetes responsible for HP

Answer 5

Micropolyspora and Thermoactinomyces

Question 6

Antigens (2) responsible for hot tub lung

Answer 6

Cladosporium spp. and Mycobacterium avium complex

Question 7

Antigen responsible for Japanese-summer type HP

Answer 7

Trichosporon spp.

Question 8

Antigens responsible for metalworking fluid lung

Answer 8

Mycobacterium spp. and Pseudomonas spp.

Question 9

Antigen found in infested wheat flour responsible for miller’s lung

Answer 9

Sitophilus granarius

Question 10

HP caused by Penicillium glabrum and Chrysonilia sitophila from cork dust

Answer 10

Suberosis

Question 11

Antigen responsible for winegrower’s lung

Answer 11

Botrytis cinerea

Question 12

Antiretroviral drug associated with HP

Answer 12

Efavirenz

Question 13

Antituberculous medication associated with HP

Answer 13

Isoniazid

Question 14

In HP, increase in these cells in lavage fluid has been associated with lung fibrosis

Answer 14

Polymorphonuclear leukocytes

Question 15

Clinical manifestation of HP with the greatest predictive value for mortality

Answer 15

Pulmonary fibrosis

Question 16

This part of the lung is commonly spared in HP

Answer 16

Apex

Question 17

Procedure of choice for imaging in HP

Answer 17

High-resolution chest CT

Question 18

Triad of subacute HP on lung biopsy

Answer 18

Mononuclear bronchiolitis, interstitial infiltrates of lymphocytes and plasma cells, and single, nonnecrotizing, randomly scattered parenchymal granulomas without mural vascular involvement

Question 19

Transient fever and muscle aches, with or without dyspnea and cough; absent serum precipitins, normal chest x-ray; associated with heavy exposure to organic dusts

Answer 19

Organic dust toxic syndrome

Question 20

Fever, chills, cough and pulmonary infiltrates within a few hours of exposure to moldy silage; absent precipitins

Answer 20

Pulmonary mycotoxicosis

Question 21

Pattern of bronchiectasis in ABPA

Answer 21

Central

Question 22

Main diagnostic criteria for ABPA (6)

Answer 22

(1) Bronchial asthma, (2) central bronchiectasis, (3) peripheral eosinophilia (more than 1000/uL), (4) immediate wheal-and-flare to A. fumigatus, (5) pulmonary infiltrates, (3) elevated serum IgE, (6) serum precipitins to A. fumigatus

(BCPIPES)

Question 23

Most common cause of ABPA

Answer 23

Aspergillus fumigatus

Question 24

Tropical eosinophilia is usually caused by infection with these organisms

Answer 24

Filaria

Question 25

Most common cause of eosinophilic pulmonary infiltrates in the US

Answer 25

Drug-induced eosinophilic pneumonias

Question 26

Benign, acute eosinophilic pneumonia of unknown cause characterized by migrating pulmonary infiltrates and minimal clinical manifestations; may be secondary to drugs or parasites

Answer 26

Loeffler’s syndrome

Question 27

BAL fluid finding in acute eosinophilic pneumonia

Answer 27

Greater than 25% eosinophils

Question 28

Normal eosinophil (%) in BAL fluid in nonsmokers

Answer 28

Less than 2%

Question 29

Level of eosinophilia and duration in hypereosinophilic syndrome

Answer 29

More than 1500 eosinophils/uL for 6 months or longer

Question 30

Heart valve commonly involved in hypereosinophilic syndrome

Answer 30

Tricuspid valve

Question 31

Surgery associated with hypereosinophilic syndrome

Answer 31

Lung/bone marrow transplantation

Question 32

Malignancy associated with hypereosinophilic syndrome

Answer 32

T cell lymphoma

Question 33

Internationally, this is the most common form of HP

Answer 33

Bird breeder’s lung

Question 34

Most common cause of pediatric HP

Answer 34

Bird breeder’s lung

Question 35

Most common cause of pulmonary infiltrates with eosinophila worldwide

Answer 35

Parasitic infestation